Web-based Survey Tool Research Articles

P-1649. Nursing Home Clinician Rationales Underlying Antibiotic Decision-Making for Suspected Urinary Tract Infection

Abstract Background The factors underlying antibiotic decision-making in nursing homes (NHs) remains poorly understood. We conducted an analysis of discrete and free text responses from a mixed-methods survey presenting NH clinicians with two patient clinical vignettes on asymptomatic bacteriuria (ASB) and cystitis (CYS) designed to assess clinicians’ treatment (TX) threshold.Table 1:Clinical Vignettes Methods NH clinicians were recruited nationally via professional organizations from December 2021 to April 2022. A web-based survey tool was used to administer the vignettes (Table 1) to participants who were asked to document their TX decision and justification. Treater (TRT) and non-treater (NTRT) responses were stratified by vignette and textual responses were uploaded to NVivo. A hybrid directed and conventional content approach was utilized to develop a codebook using the constant comparison technique.Table 2:Factors Contributing to Clinicians’ Treatment Decisions by Vignette and Treatment Choice Results Among 298 survey respondents; 10.4% treated ASB while 61.1% treated CYS. Seven factors contributing to clinicians’ TX decisions were identified (Table 2). For the ASB vignette (Table 3), TRTs framed the patient’s positive test results as infection (84%) while NTRTs framed it as contamination (79%). TRTs were less likely than NTRTs (26% vs 91%) to note the absence of signs and symptoms (S/S). Both groups cited the patient’s comorbidities and/or medical history (42% vs. 54%) in their TX decision. In the CYS vignette (Table 4), TRTs focused on positive patient S/S (91%) while NTRT did not feel there were sufficient frequency or severity of symptoms to justify immediate therapy (77%). TRTs were more likely to rely on positive test results (59%) and have more concern for patients’ comorbidities and/or medical history (18%).Table 3:Asymptomatic Bacteriuria Vignette Illustrative Quotes Conclusion Both TRTs and NTRTs use urine diagnostics in their decision-making, with TRTs having more confidence in the positive predictive value of urine diagnostics. NTRTs highlighted the lack of S/S as a justification for withholding therapy in both vignettes. TRTs accurately identified S/S for CYS, however, TRTs for ASB expressed concern that S/S might be underreported. This study shows how TRTs and NTRTs justify their rationales, however the next steps involve understanding how these decision-making patterns are amenable to education, information framing and/or risk management interventions.Table 4:Cystitis Vignette Illustrative Quotes Disclosures Robin Jump, MD, PhD, Abacus: Grant/Research Support|Merck: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support

Specialist training in infectious diseases in Europe.

The objectives were to determine the structure of training programmes and assessment of physicians training to become infectious disease (ID) specialists in Europe in early 2024, and to document the provision of specialists, trainees and training centres in each country. Delegates to the ID Section and Board of the European Union of Medical Specialists (UEMS) entered national data on a web-based survey tool in late 2023-early 2024. Results were compared to UEMS recommendations on the structure and content of postgraduate training in ID in Europe (2018), and to results of a similar survey in early 2021. Responses were received from all 35 countries; 27/35 (77%) recognise ID as an independent speciality and 7/35 (20%) as a subspeciality. Spain does not officially recognise the speciality. In Cyprus, Iceland, and Luxembourg, despite official recognition of the sub-/speciality, ID training must be completed abroad. Paediatric ID was recognised in 16/35 (46%) countries. The number of adult ID specialists varied from 78.8 per million inhabitants in Sweden to 0.6 in Germany. Only 7/31 (23%) national programmes provide the minimum recommended 6months of training in medical microbiology. Assessment methods included logbooks/portfolios in 25/31 (81%), final examinations in 25/31 (81%) and workplace-based assessments in 21/31 (68%). There has been little change since 2021 in speciality status or in structure and content of training programmes across Europe. There have been large increases in training position numbers in several countries, possibly in response to COVID-19. Continued low compliance with the 2018 recommendations to increase exposure to medical microbiology during training highlights the slow pace of change. Logistic barriers to change and to harmonization across Europe remain and are discussed in the context of published concerns of trainees.

Participatory multi-criteria decision making for optimal siting of multipurpose artificial reservoirs

Water resources management is a crucial activity due to climate change concerns and increasing water scarcity. The increase of water storage by building new artificial reservoirs is one of the most common solutions to fulfill the community's needs for potable water, energy, irrigation, and prevention of flood risk. The siting of the reservoirs is usually assessed based on topographical and hydrological considerations. However, there are additional crucial factors, often disregarded in common engineering top-down design approaches, that should be considered to determine suitable locations, such as bio-physical, socio-economic, regulatory, and environmental factors, especially where there are competing interests in the use of territory. Involving the communities in the initial stages of the decision-making process is therefore crucial. In this work, we present a methodology, based on multi-criteria decision-making analysis (MCDA), for identifying the optimal locations for new reservoirs while simultaneously addressing all the aforementioned factors through community engagement. The presented method aims at overcoming two major challenges in existing works, i.e., retrieving quantitative information from the participatory approach and going beyond standard hydro-morphological suitability of a dam site. In a first step, an algorithm assesses a large number of sites using a Digital Elevation Model (DEM). Then, MCDA is conducted to rank all potential locations. The selection criteria are defined quantitatively, based on a territorial analysis combined with hydrological modelling. The criteria include: geometric and morphological aspects (reservoir volume, etc.), hydrological indicators (water balance, potential flood mitigation), anthropization (population, infrastructures, etc.), landscape, archaeological heritage, ecology, environmental components and natural hazards. A web-based survey tool based on the pairwise comparison is developed to engage the community in the decision-making process, allowing them to express their perspectives on the relative significance of each criterion. The application of this methodology is demonstrated through a case study in the Pesa river watershed, Italy, showcasing its effectiveness in identifying the most suitable reservoir locations while targeting the highest environmental preservation and community acceptance. The results show that sole engineering criteria might not reflect the sensibility of the community and that variations of the size of the dam can lead to distinct trade-offs between costs and benefits where interference with impact elements occurs.

Effects of Web-Based Survey Tool and Public Health Services for Low-Cost Detection of Vulnerable Medication Errors Using Telepharmacy

Telepharmacy, in which prescription requests are reviewed and approved online by a pharmacist in a different geography, is an effective way to lower the number of mistakes made when giving medicines. However, not enough studies have been done on the benefits of error reduction and the possible cost savings that come with these teleservices. This paper discusses a study examining what happened when a web-based survey tool and telepharmacy solutions were used to find Vulnerable Medication (VM) errors and low-cost Public Health (PH) services. It is very important to get each patient's drug records when they come into the Emergency Room (ER) so that any mistakes in their current medication record can be found. The trained pharmacists were interviewed after using a safe online tool to keep track of drug information. Details about each patient were gathered, along with the amount and type of VM and any PH errors found during the data-gathering procedure. From May 2022 to November 2022, 190 patient files were successfully filled up utilizing the survey instrument throughout the experimental period. Among the 1090 drugs documented, 41.38% were classified as drugs of high risk. 42.33% of possible prescription mistakes were categorized as VM errors. This online survey tool has enhanced the caliber and effectiveness of identifying possible errors during the gathering of medication records by pharmacists. This data may be readily accessed and contribute to debates about the reconciliation of drugs at the management level. It can also positively affect patient care outcomes by facilitating the development of virtual procedures that may reduce drug-related incidents.

Self-Reported Social Determinants of Health and Area-Level Social Vulnerability

Many health care systems are investing resources in identifying social determinants of health (SDoH) needs and facilitating interventions among the populations they serve. Because self-reported SDoH information is lacking, area-level measures are often used to estimate needs and direct resources. To describe the large-scale deployment of SDoH assessments by a health system and determine the extent to which self-reported SDoH needs identified therein are associated with census tract-level social vulnerability measured using the Social Vulnerability Index (SVI). This cross-sectional study assessed SDoH needs between January 1, 2020, and April 30, 2023, in both payer and clinical care settings. Modalities included telephonic outreach, face-to-face clinical interactions, self-entry into a tablet or kiosk, and web-based survey tools. Participants included individuals who responded to the assessment and had sufficient information for census tract identification. Respondents included both Highmark Health Plan members and nonmembers. Health plan members responded to the assessment through health plan programs or platforms, and both members and nonmembers responded to assessments during inpatient or outpatient encounters with the affiliated health system. Overall and domain-specific SDoH needs self-reported through assessments, and severity and complexity of needs identified. Residential social vulnerability measures included overall SVI and the 4 conceptual themes comprising overall SVI. In total, 841 874 assessments were recorded for 401 697 individuals (55.1% women; median [IQR] age, 55 [41-70] years). Social determinants of health needs were identified in 120 769 assessments (14.3%). Across all SDoH domains, increasing SVI was associated with a higher positivity rate (eg, 11.2% of those residing in the lowest-risk SVI quintile reported a need compared with 22.7% among those residing in the highest-risk quintile). Associations varied by SDoH domain and SVI theme. After adjusting for demographic and screening characteristics, odds of positive screening among those residing in the highest-risk SVI quintile were 1.74 (95% CI, 1.62-1.86) to 3.73 (95% CI, 3.48-4.00) times the odds among those residing in lowest risk quintile. In this cross-sectional study, the overall level of SDoH needs generally corresponded to area-level vulnerability. Some SDoH domains appeared far more sensitive to community characteristics than others. Notably, even among individuals from the highest-risk areas, the positive screening rate was roughly 1 in 4. These findings underscore the importance of individual-level SDoH data for service provision planning and health services research.

Community-Based Organizations Leading Research Efforts: Preliminary Findings from the Chicagoland CEAL Program's COVID-19 Vaccine Uptake and Intention Survey.

To foster community engaged research in the communities most impacted by COVID-19, the National Institutes of Health (NIH) formed 21 teams of Community Engagement Alliance Against COVID-19 Disparities (CEAL). The national CEAL initiative developed a Common Survey to investigate attitudes and behaviors to the COVID-19 vaccine and clinical trials. This article describes survey implementation at the Chicagoland CEAL Program (CCP). This community-based participatory research project was the result of a strong collaboration between academic institutions, and a community-based non-profit health equity-focused partner organization. The survey implementation was developed and refined with strong input from CHWs, participants, and staff in the partner organizations and institutions. Survey data were collected with Qualtrics, a web-based survey tool. Survey implementation resulted in data collection for 852 participants during the period 12/18/2021-02/18/2023. Excluding participants on the basis of missing data resulted in a sample of 690, 601 of which (87.10%) indicated that they had received at least one dose or intended to get vaccinated. Overall, 54 (7.83%) respondents reported that they had not received the vaccine and were not planning to. Hard to reach populations present two unique challenges in emerging infectious disease events. Reaching populations vulnerable to poor outcomes with vaccines was essential to addressing the COVID-19 pandemic. Additionally, learning about barriers and hesitancy toward vaccine uptake is difficult in these communities. CCP's partnership of five academic institutions, a community research center, and a community-based non-profit health equity-focused organization shows what is possible when traditional models of research and inquiry are reconsidered for community-based participatory research. Results shown here are drawn from a collaboratively designed and implemented survey, collected in person, with over 90% completion.

Asian flush is a potential protective factor against COVID-19: a web-based retrospective survey in Japan

Coronavirus disease 2019 (COVID-19), first reported in December 2019, spread worldwide in a short period, resulting in numerous cases and associated deaths; however, the toll was relatively low in East Asia. A genetic polymorphism unique to East Asians, Aldehyde dehydrogenase 2 rs671, has been reported to confer protection against infections. We retrospectively investigated the association between the surrogate marker of the rs671 variant, the skin flushing phenomenon after alcohol consumption, and the timing of COVID-19 incidence using a web-based survey tool to test any protective effects of rs671 against COVID-19. A total of 807 valid responses were received from 362 non-flushers and 445 flushers. During the 42 months, from 12/1/2019 to 5/31/2023, 40.6% of non-flushers and 35.7% of flushers experienced COVID-19. Flushers tended to have a later onset (Spearman's partial rank correlation test, p = 0.057, adjusted for sex and age). Similarly, 2.5% of non-flushers and 0.5% of flushers were hospitalized because of COVID-19. Survival analysis estimated lower risks of COVID-19 and associated hospitalization among flushers (p = 0.03 and <0.01, respectively; generalized Wilcoxon test). With the Cox proportional hazards model covering 21 months till 8/31/2021, when approximately half of the Japanese population had received two doses of COVID-19 vaccine, the hazard ratio (95% confidence interval) of COVID-19 incidence was estimated to be 0.21 (0.10-0.46) for flusher versus non-flusher, with adjustment for sex, age, steroid use, and area of residence. Our study suggests an association between the flushing phenomenon after drinking and a decreased risk of COVID-19 morbidity and hospitalization, suggesting that the rs671 variant is a protective factor. This study provides valuable information for infection control and helps understand the unique constitutional diversity of East Asians.

Care Patterns and Barriers to Outpatient Care for Adults with Acute Myeloid Leukemia (AML) Following Intensive Chemotherapy at National Comprehensive Cancer Network (NCCN) Institutions

Background: Prolonged hospitalization following intensive (re)induction chemotherapy until resolution of cytopenias is the current standard of care for adults with acute myeloid leukemia (AML), but this approach is costly, resource intense, contributory to hospital bed shortages, and negatively impacts patients' quality of life (QOL). Early hospital discharge (EHD) immediately following completion of chemotherapy has been proposed as an alternative and has proven safe at select institutions. Here, we conducted a National Comprehensive Cancer Center (NCCN) survey, through its Best Practices Committee (BPC), to examine discharge practices for adults with AML at other major cancer centers to better understand interest in, and barriers to, adopting an EHD approach more broadly. Methods: NCCN is a non-profit alliance of 33 cancer centers in the U.S. The survey was developed by 2 physicians at one center and piloted at 2 other centers. The NCCN BPC, which is composed of senior physician, nursing, and administrative leaders from NCCN Member Institutions, distributed the survey in early 2023 via a web-based survey tool (SurveyMonkey, San Mateo, CA) to a representative at each center, requesting completion by a content area expert. No incentives were offered for completion. Data were analyzed using descriptive statistics. Results: 30/33 (91%) centers completed the survey, 60% of which treat &amp;gt;100 AML patients annually and 45% treat over half of their patients with intensive chemotherapy (7+3 or regimens with a high-dose cytarabine backbone). All centers perform allogeneic hematopoietic cell transplantations (HCT). There was no difference in the proportion of intensively treated patients across centers by patient volume. Following (re)induction therapy, 80% of institutions keep patients hospitalized until blood count recovery, whereas 20% attempt to discharge patients early if medically stable and logistics permit. Concerns regarding patient safety, housing, and caregiver availability were the main reasons for keeping patients hospitalized ( Figure 1). In contrast, following post-remission (“consolidation”) therapy, 87% of centers discharge patients early. Concerns regarding increased care needs, worse functional status, and higher complications risks following induction relative to post-remission therapy accounted for the main reasons for this difference ( Figure 2). 80% of centers were interested in exploring EHD after (re)induction but noted barriers including affordable local housing (71%), transportation (50%), high toxicity/infection rate (50%), high transfusion burden (50%) and limited bed availability when re-hospitalization is necessary (50%). Among the 6 centers that practice EHD, all have infusion centers with full weekday hours, 5 have full weekend/holiday hours, 3 more have evening hours, and 1 has reduced holiday/weekend hours. All can provide blood product support within 4 hours from ordering and administer IV antimicrobials within 1 hour from ordering in outpatient clinic. In 4 centers, evaluation of a patient with presumed neutropenia contacting the clinic with fever during regular hours can occur in the outpatient clinic, with subsequent admission if necessary; at one center the patient would be referred to the ED and at one center the patient would be directly admitted to an inpatient ward. If a patient needs admission, a bed would be available for direct admission to the inpatient ward in 4/6 of the centers &amp;gt;75% of the time, at 1 center 26-50% of the time, and at 1 center &amp;lt;25% of the time. EHD was not practiced at any centers in cities with population of &amp;gt;1 million, citing local housing availability as a major EHD barrier. There was no correlation between the ability to practice EHD and annual AML patient volume, treatment intensity patterns, or hospitalization practices following HCT. Conclusions: Hospitalization and care patterns following AML therapy are highly variable across major U.S. cancer institutions. While only 20% of major cancer centers surveyed practice EHD following intensive (re)induction chemotherapy, 87% do so following post-remission therapy. There is interest in exploring this approach despite medical and logistical barriers. Given potential advantages of EHD for both patients and healthcare systems, strategies to address these barriers should be explored to reduce healthcare resource utilization and improve patients' QOL.

2951. Nursing home clinician characteristics associated with simulated urinary tract infection treatment decision-making

Abstract Background Antibiotic overuse and misuse are common in nursing homes (NHs). Urinary tract infection (UTI) is the most common indication for antibiotics in NHs. We conducted a clinical vignette experiment to identify clinician-level characteristics associated with suboptimal UTI treatment decision-making among a sample of NH clinicians. Methods Six clinical vignettes, two designed to assess clinicians’ treatment threshold and four designed to assess antibiotic choice decision-making, were created through an iterative process. NH clinicians were recruited nationally via professional organizations from December 2021 to April 2022. Clinical vignettes were shared using a web-based survey tool (Qualtrics) during which participants were asked if they would initiate antibiotics and which one. Participants provided demographic information, including degree, specialty training and NH experience. A multivariable logistic regression model with the decision to initiate antibiotic therapy (Yes/No) as the dependent variable and a multivariable ordinal regression model with number of vignettes for which a fluoroquinolone (FQ) was empirically chosen as the dependent variable were constructed in R. Results A total of 298 NH clinicians, whose characteristics are detailed in Table 1, responded to the survey. Despite national guidelines not recommending treatment for asymptomatic bacteriuiria (ASB), 10.4% of participants chose to initiate antibiotics when presented with the ASB vignette. Physicians (vs. APPs) and clinicians with ≥ 10 years NH experience were less likely to initiate antibiotics for ASB (Table 2). Empiric treatment was withheld for simple cystitis by 38.9% of clinicians, with APPs more likely to withhold antibiotics than physicians (Table 2). Across the four cases assessing empiric antibiotic choice, 38.3% of clinicians chose a FQ in at least one clinical case (Table 1). Clinicians with more years of NH-practice experience were more likely to prescribe a FQ (aOR 2.41, 95% CI 1.47-3.95, p&amp;lt; 0.01, Table 2). Respondent Characteristics Abbreviations: Advanced Practice Provider (APP); Asymptomatic bacteriuria (ASB); Fluoroquinolone (FQ), Nursing Home (NH). Effect of clinician credentials, training, and experience on antibiotic prescribing for urinary tract infection Abbreviations: * reference; Adjusted odds ratio (aOR); Confidence interval (CI); Asymptomatic bacteriuria (ASB); Advanced practitioner (APP) Conclusion Our results indicate that specific clinician characteristics are associated with suboptimal antibiotic prescribing. This suggests that tailoring stewardship interventions to clinician-specific factors may augment ongoing efforts to improve antibiotic use in NHs. Disclosures Lindsay Taylor, MD, MS, Merck: Grant/Research Support Robin Jump, MD, PhD, Merck: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support

1.M. Workshop: Health Services Research in Europe: time to dust off the field

Abstract Since the 90s, and in spite of major transformations in health systems and the new challenges they face (e.g. rising social inequities, labour shortages), the health Services Research (HSR) field has seen little evolution in the definition of the ground it covers. In 2021, researchers from the EHESP School of Public Health (France) launched a CNRS- and INSERM-funded research team devoted to Health Services and Management Research. To mark the event, a seminar was held to reflect on what HSR stands for today and the specific contributions of our team to the field. In this workshop, Eric Breton will first briefly present the summary of the conclusions of the seminar and the topic areas our research team addresses. He will point to the specificities of HSR in the context of strong European welfare regimen and the importance of recognising the impact upstream social determinants of health have on health systems. We will then move on to our panellists who will, through their own research, question the current perspectives on HSR and highlight new advances in methodological approaches and tools at hand. Here is the list of topic we will cover. For our first panellist, Nicolas Sirven, the HSR scene is witnessing the coming of age of public policy evaluations in Europe, which is reflected in enhanced capacities to inform health system governance. He will argue that European health systems are increasingly collecting and giving access to large datasets. These datasets stand out as they cover whole populations or at least large shares of them. They will stress the importance of making the best of new evaluation approaches and methods that not only inform on impacts and outcomes but also on contextual conditions for policies to deliver. Drawing lessons from his work on access to kidney transplantation waiting list, Latame Komla Adoli will raise the issue of gender discrimination in health services. After presenting the evidence of this gender gap, he will demonstrate the capacity of HSR to provide valuable insights on how to close the gender gap and the importance of combining bio-statistical analyses with qualitative investigations. Nolwenn Le Meur-Rouillard will share insights on how big data and new data collection tools are opening up a new landscape for HSR. E-health devices, social networks, and electronic medical records (EHR) are all sources that can feed HSR making possible ‘real-life’ longitudinal studies on the entire population of a territory. This is offering a renewed vision of the disparities in access to and use of healthcare services. Carla Perrota, from the University College Dublin will conclude the workshop by offering some general remarks on the French HSR agenda and provide an account of her vision on the future of HSR. This interactive workshop will be facilitated by a web-based survey tool to further engage members of the audience. Highlights of the workshops will be published in a short paper. Key messages • Most definitions of health services research limit investigation to health care services; a situation that does not reflect the scope of actions of the strong welfare systems of Europe. • From a social determinant of health perspective, health services research needs to address programmes and policies governments deliver beyond health care to promote population health and equity.

Validation of measurement scales for undergraduate students' self-perceived employability and university commitment in the United Arab Emirates

PurposeThe purpose of this study is to validate the psychometric properties of the Self-Perceived Employability Scale in the context of the United Arab Emirates (UAE-SPE) and to verify the model fit of the UAE-SPE and University Commitment Scale (UC) (Rothwell et al., 2008) for undergraduate students.Design/methodology/approachA cross-sectional survey study was carried out to collect the data using a web-based survey tool (Qualtrics) at a public university in the UAE. The sample was 646 undergraduate students.FindingsAs a result of the factor analysis, the study validated three factors of SPE for undergraduate students in the UAE that explain their perceptions of their university reputation, their field of study, the state of the UAE labour market and confidence in their skills. Confirmatory factor analysis verified good model fit indices of UAE-SPE and the UC scale. In addition, the study found a statistically significant positive relationship between the UC scale and the three factors of UAE-SPE.Originality/valueCurrently, there is a scarcity of published research on self-perceived employability amongst undergraduate students in higher education institutions in the UAE and the Arab region. This article not only contributes to research on this topic but also validates two scales, allowing cross-cultural comparisons of SPE and UC of undergraduate students in the Arab region and worldwide.

Patient involvement in quality improvement: a survey comparing naturalistic and reflective approaches

BackgroundThis study investigates reflective and naturalistic approaches to patient involvement in quality improvement. The reflective approach, using, for example, interviews, provides insights into patient needs and demands to support an...

Experience and opinions relating to pregnancy in patients with chronic intestinal failure: an international survey

IntroductionPregnancy in patients with chronic intestinal failure (CIF) is a relatively rare occurrence but is an important contemporary topic given both the increasing use of home parenteral nutrition (HPN) and...

Methods for detecting probable COVID-19 cases from large-scale survey data also reveal probable sex differences in symptom profiles.

Daily symptom reporting collected via web-based symptom survey tools holds the potential to improve disease monitoring. Such screening tools might be able to not only discriminate between states of acute illness and non-illness, but also make use of additional demographic information so as to identify how illnesses may differ across groups, such as biological sex. These capabilities may play an important role in the context of future disease outbreaks. Use data collected via a daily web-based symptom survey tool to develop a Bayesian model that could differentiate between COVID-19 and other illnesses and refine this model to identify illness profiles that differ by biological sex. We used daily symptom profiles to plot symptom progressions for COVID-19, influenza (flu), and the common cold. We then built a Bayesian network to discriminate between these three illnesses based on daily symptom reports. We further separated out the COVID-19 cohort into self-reported female and male subgroups to observe any differences in symptoms relating to sex. We identified key symptoms that contributed to a COVID-19 prediction in both males and females using a logistic regression model. Although the Bayesian model performed only moderately well in identifying a COVID-19 diagnosis (71.6% true positive rate), the model showed promise in being able to differentiate between COVID-19, flu, and the common cold, as well as periods of acute illness vs. non-illness. Additionally, COVID-19 symptoms differed between the biological sexes; specifically, fever was a more important symptom in identifying subsequent COVID-19 infection among males than among females. Web-based symptom survey tools hold promise as tools to identify illness and may help with coordinated disease outbreak responses. Incorporating demographic factors such as biological sex into predictive models may elucidate important differences in symptom profiles that hold implications for disease detection.

Impact of a Well-being Promotion Training Program on Advanced Pharmacy Practice Experience Conference Leaders

Objective. The objective of this pilot study was to evaluate the attitudes and self-efficacy of advanced pharmacy practice experience (APPE) conference leaders after completing the Well-being Promotion (WelPro) training program developed at the University of California, San Francisco (UCSF) School of Pharmacy.Methods. The WelPro training program was developed to equip participants with the knowledge and tools to assist APPE students in distress and promote student wellness. After completing the WelPro training program, a 20-item survey was administered to 10 conference leaders via a web-based survey tool to assess their attitudes about burnout and self-efficacy in assisting students in distress. Descriptive statistics were used to characterize attitudes and self-efficacy.Results. Ten conference leaders participated in the training program. Of these, nine reported experiencing burnout in their careers, and all believed burnout within the pharmacy profession could be avoided. After the WelPro training program, confidence levels of the conference leaders significantly improved in the following areas: identification of students in distress, identification of resources for students, and recognition of when and how to refer students in distress.Conclusion. Increased self-efficacy of conference leaders to identify and assist students in distress could be translated into their improved ability to support students' overall well-being. The WelPro training program can serve as a model for similar wellness training programs that directors and preceptors in experiential education can implement at their institutions.

Shift in survivorship care delivery.

230 Background: Survivorship care often occurs within a single visit at the end of treatment to discuss a treatment summary and/or survivorship care plan with a patient. With increased understanding of both immediate and long-term effects of cancer and cancer treatment we need to consider support for the patient from the time of diagnosis through the end of the patient’s life. In this quality improvement (QI) initiative, a team of survivorship stakeholders utilized survey and focus group methodology to develop a set of recommendations to support a large, academic medical center in a rural setting to move toward this holistic notion of survivorship care. Methods: Surveys regarding experience with survivorship care were deployed to oncology providers, allied health providers, and patients and care partners. Surveys were deployed via a web-based survey tool using email groups and lists developed by the oncology department, as well as printed handouts with the survey URL and a QR code available to patients during clinic visits. A focus group was conducted with oncology APPs to discuss findings and to develop recommendations to support survivorship care delivery. Results: Responses received from 59 patients, 20 care partners, 24 allied health providers, and 19 providers. Over half (52.6%) of patients and care partners indicated that survivorship services were “very important” to their care, with less than 10 respondents (11.5%) indicating that they were “not at all important.” Providers indicated that they do discuss and/or provide survivorship support to their patients (84.2% of respondents), but almost 80% indicated that they were only somewhat knowledgeable (36.8%) or not knowledgeable at all (42.1%) about survivorship services available to patients and care partners. Both allied health and providers indicated that documenting survivorship care was complex. Only 12.5% of providers indicated that patients had a formal survivorship visit; instead, providers indicated that survivorship care is incorporated into routine follow-up visits (75%) and/or active treatment visits (50%). Both allied health (60.0%) and providers (69.2%) indicated that documentation, if done at all, was entered through a free text note. Many acknowledged that this made data tracking, whether for continuity of care or program analysis purposes, labor-intensive. Conclusions: This QI initiative revealed the need for two supportive mechanisms to facilitate the shift from survivorship care that’s limited to a dedicated visit type or tied to a specific document to survivorship care that is woven into all aspects of a patient’s treatment and life beyond treatment. The first mechanism is a robust set of informational resources to ensure providers are knowledgeable about the services that are available to their patients and the referral mechanisms for those services. The second is a mechanism within the EHR to allow survivorship notes to be entered into any visit type and be extracted easily from the system.

Understanding the Impact of Conflict on Risk Perceptions and Travel Behaviour: Attitudes of Dutch Pilgrims and Tourists towards Palestine

This research aims to get a better understanding of the impact of conflict on risk perceptions and attitudes of affecting Dutch travel behaviour towards Palestine. The research process involved an online self-administered method created with one of the leading research and web-based survey tools called Qualtrics. The questionnaire was filled in by 462 respondents. Findings indicate that Palestine is perceived as an unsafe destination to travel to. Palestine is perceived as moderately appealing as a holiday destination. The weather, price, culture, and religious features are seen as important factors which are appealing to Palestine as a holiday destination. The respondents who had past travel experiences in Palestine the most were likely to revisit the destination. The advice given by friends and relatives is seen as the most trustworthy information source. Traveling with an organised tour and traveling in a group are seen as the most effective risk reduction strategies which can be applied during the trip and, therefore, could have implications for Destination Management Organisations.

COVID-19 vaccine’s knowledge, attitude, and perception of healthcare students in India after the second wave of a pandemic

Background: The COVID-19 vaccine has been increasingly discussed in India since its first approval in January 2021, prioritizing healthcare workers including healthcare students. Since healthcare students (future healthcare workers) play a vital role in vaccination coverage, this study aimed to assess the knowledge, attitude, and perception toward the COVID-19 vaccine of healthcare students after the second wave of the Pandemic. Method: A web-based questionnaire survey tool was developed, delivered over “Google Forms”, and was filled out randomly among the intended population in many states of India after the COVID-19 pandemic second wave. The questionnaire contained an informed consent form along with questions related to socio-demographics, knowledge, attitude, and perception, toward the COVID-19 vaccine. The data was collected in excel and based on the result we prepared our statistical graphs. Multivariate regression and Bivariate were utilized to identify differences among subgroups with diverse sociodemographic characteristics. Result: Most students had below-average knowledge regarding the COVID-19 vaccine. The highest percentage of correct responses were from postgraduate medical students living in urban areas and the lowest was from undergraduate nursing students living in rural areas.

Caries risk assessment-related knowledge, attitude, and behaviors among Chinese dentists: a cross-sectional survey.

To investigate caries risk assessment (CRA)-related knowledge, attitudes, and practices among dentists in China, to describe their subjective ratings of the significance of specific caries risk factors and to identify factors associated with the level of knowledge, attitudes, and use of CRA in routine clinical practice. A cross-sectional anonymous online questionnaire survey was performed. The questionnaire was distributed via WeChat (Tencent, Shenzhen, China) to practicing dentists between November 25 and December 25, 2021. For participant recruitment, we employed purposive and snowball sampling techniques. Data were collected using a specialized web-based survey tool ( www.wjx.cn ) and analyzed with descriptive statistics and regression analyses. A total of 826 valid questionnaires were collected. Only 292 (35.4%) respondents used CRA in routine practice, among whom a majority (243, 83.2%) did not use a specific CRA tool. The routine use of CRA was associated with the type of practicing office, attendance of caries-related lectures, the habit of reading caries-related literature, geographic location, and the total knowledge score. The mean total knowledge score was 3.13 (score range: 0 to 6). Knowledge levels were related to several sociodemographic characteristics, including geographic location, the type of practicing office, attendance of caries-related lectures and the habit of reading caries-related literature. The risk factor deemed most important was "current oral hygiene." Caries risk assessment has not widely entered clinical practice in China. The level of CRA-related knowledge among dentists was generally suboptimal. Strengthening CRA-related education may allow practitioners to develop a better understanding of caries risk assessment and hence promote its implementation.

The impact of terrorism on risk perceptions: An analysis of the Dutch market behavior and attitudes towards Egypt

This research aims to gain a better understanding of the impact of terrorism on risk perceptions and attitudes of Dutch travel behavior towards Egypt. The research process involved an online self-administered method created with one of the leading research and web-based survey tools called Qualtrics. The questionnaire was filled in by 414 respondents. Findings indicate that (potential) Dutch tourists are less likely to take risks when traveling with children. For instance, people that usually travel with children state to avoid traveling to countries within the MENA region because of unrest related to terrorism. Over half of the sample size would not consider traveling to Egypt due to the current travel advisory of the Dutch Ministry of Foreign Affairs. The practical implications of this research are related aimed at relevant stakeholders within the tourism industry and creating a more appealing image of Egypt as a holiday destination.